鼻内镜手术中对鼻腔解剖结构异常的处理  

Operating procedures for the treatment of anatomic abnormalities in nasal cavity during the process of nasal endoscopic surgery

作　　者：肖志勇[1] 林梅茹[1] 陈瑜萍[1] 胡顺临[1] 

机构地区：[1]福建省福州市第二医院耳鼻咽喉科,350007

出　　处：《中国中西医结合耳鼻咽喉科杂志》2007年第5期338-340,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨鼻内镜手术中对于鼻腔解剖异常情况的正确处理措施,以防止术中、术后并发症的发生。方法回顾性研究我科2002～2006年间经鼻内镜手术治疗后随访时间达6个月以上的慢性鼻窦炎-鼻息肉病例资料456例,对这些病例合并的鼻腔解剖结构异常鼻内镜下处理情况进行统计分析。结果本组病例中,治愈率78.5%,好转率19.7%,无效率1.8%。轻微并发症出现率10.3%,包括眶周皮下瘀血8例,暂时性牙或唇麻木10例,需要再次填塞止血的术后鼻出血7例,术后鼻腔粘连22例;严重并发症出现率0.4%,包括眶内出血1例,溢泪1例。结论鼻窦CT扫描可清楚显示鼻腔、鼻窦解剖学异常,是术前确定处理方法的可靠依据;术者对该部解剖结构的熟悉程度以及手术操作熟练程度是避免并发症的关键因素。Objective To explore the operating procedures for the ideal treatment of anatomic abnormalities in nasal cavity in order to prevent possible complications from occurring during and after the nasal endoscoic surgery and to improve the curative effects of the surgery on the lesions. Methods A retrospective study was carried out in a group of 456 patients with chronic sinusitis and/or nasal polyps treated in our Hospital from 2002 to 2006, with a following up period lasted for more than 6 months. Analyzed among all these patients were the treating procedures used for the anatomic abnormalities in nasal cavity accompanying these cases during the period of nasal endoscopic surgery. Results In this group of cases, the curative rate was 78.5 %, improving rate was 19.7 % and the ineffective rate was 1.8 % following such treatment and as evaluated by the end of following up period. The occurring rate of minimal complications is 10.3 %, including 8 cases with peri-orbital ecchymoma, 10 cases with temporary numbness in teeth and/or lips,7 cases with epistaxis retreated by nasal packing and 22 cases with nasal adhesion manifesting selves as obvious nasal symptom, and that of severe complications is 0.4 %, including 1 case with orbital hemorrhage and 1 cases with lacrimation. Conclusions CT scanning on nasal sinuses can clearly demostrate the anatomic abnormalities in nasal cavity and/or sinuses and it may provide reliable image evidences for preoperative decision making on the treating procedures taken for such anatomic abnormalities. Furthermore, the more important key factors for preventing possible complications from occurring during and after the operation should be the operator＇ s knowledge about the anatomic structures in nasal cavity and sinuses and the skill of operation under nasal endoscopy.

关 键 词：鼻窦炎 鼻内镜手术 并发症 解剖因素 

分 类 号：R765[医药卫生—耳鼻咽喉科]